How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,089.30 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,466.84 Typical High $4,786.30 | Facility | None | $3,548.13 | $4,466.84 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,691.53 | $2,951.21 | $4,466.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $380.19 | Professional | RR · Rental | $269.15 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,754.23 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,606.93 | Facility | None | $6,456.54 | $6,456.54 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,466.84 | Facility | None | $3,090.30 | $3,090.30 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $21,877.62 | Professional | None | $2,238.72 | $3,090.30 | $21,877.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $6,606.93 Typical High $14,125.38 | Facility | None | $912.01 | $6,606.93 | $14,125.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $6,309.57 | Professional | None | $2,818.38 | $3,715.35 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,318.26 | $2,187.76 | $3,715.35 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,047.13 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $891.25 | Professional | 53 · Discontinued | $416.87 | $416.87 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $660.69 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $446.68 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $446.68 |
Where Indiana sits
The same service costs 2.0 times more in Montana than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 31st of 51
$2,692
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.